Welcome to HIMSS15 Day 2
Being a process improvement guy, I set-out to improve my process for attending HIMSS today by getting coffee BEFORE the 45 minute Starbucks line. Feeling good with my early success, I decided to improve the shuttle process by hailing a cab. Let’s just say, I’m one-for-two today…
Opening Keynote: Bruce Broussard, President and Chief Executive Officer, Humana
I arrived late to the session and missed the video that everyone was discussing. I’ll need to see if that is available somewhere, but I was there to hear the main point of the discussion: changing the conversation.
“We are making progress, but our perspective is inhibiting progress. The problem is in this room, we don’t need another technology, we need to change perspective and be bold leaders in changing healthcare.”
Insurance companies need to make it easier: preauthorization, paying, approving care, and asking how can we help people improve their health
Providers: The conversation needs to change from a volume-based model to a value-based model. It’s the quality of care and improved outcomes that need to matter.
Tech companies need to shift their focus to look at information as a shared asset, not as a proprietary asset. Interoperability is a good place to start because we can all benefit from greater data sharing.
Humana’s Goal: The communities we serve will be 20% healthier by 2020 because we make it easy for people to achieve their best health.
In the end, this was a very good presentation with a lot of great thoughts; I just hope our culture can shift to look at the value of care versus the number of visits.
HIMSS15 is big, but just to add emphasis to the word big, they have posted a number of statistics for us to see when walking from location to location.
- The exhibit space is 1.3 million square feet or around 22 football fields
- This conference will book 90 hotels this week, accounting for over 90,000 rooms (you’re welcome Chicago).
Personally, I can vouch for the size of this place because each day I’ve moved literally from one end of the conference center to the other at least twice.
Session 1: HIT Alone Isn’t Enough: Humanizing Patient Engagement
While the majority of my focus is on internally facing systems, we are all in their business to ultimately improve the patient experience and outcomes.
The session will focus on building a statewide patient portal. Patients are more satisfied when they have access to their medical information online and they are more empowered in their own care.
Kentucky is a tobacco state and has the highest cancer rate in the country and frankly, “Our health rankings in Kentucky suck.” They are working to move the needle, but “Y’all move your needles faster!” All joking aside, the challenges in Kentucky are real and they have set good goals and are making progress.
Kentucky has a successful state-based HIE and they have reduced their uninsured rate from over 20% to under 10%. Their PHR is called myHealthNow. Their efforts provide a good reminder to place the patients at the center of efforts, involving and aligning with stakeholders, have a plan and collaborate whenever possible. It is interesting to me how the truly successful programs all seem to follow this similar pattern. Our stakeholders and customers must be an integral part of system design/configuration/deployment for it to truly transformative.
Lunch at HIMSS15 has been cancelled due to overwhelming lines and the promise of Girodano’s for dinner tonight. I did have the opportunity to catch-up with a vendor who I’ve worked with quite a bit over the past four years, once again proving the value of face-to-face interactions.
Session 2: Mobile, Digital & Connected Health: A Status Update
Great start: This will be a bit more patient facing and leading edge other sessions. Three is a large appetite for virtual care. My expectation level just went up.
5 Key Aspects of Personal Connected Health
- feedback loops
- motivational engagement
- Integrated into everyday life to succeed
- improved outcomes correlated with engagement
- Interoperability wand frictionless technology are critical
The ultimate goal is to integrate care into the day-to-day lives of our patients at Connect Health, your healthcare should follow you and be top of mind.
Two value propositions have been proven by their efforts.
- Just-in-time care – make much better decisions for your care based on feedback when it is needed.
- Improved self-care – an unexpected outcome of the study, but something that will be the savior for healthcare going forward. The concept is, a more informed patient who receives feedback would do a better job of self-care.
Feedback Loop – If I can collect something objectively about you and send it back, it becomes a source of truth, stays top-of-mind and can lead to quantifiable goals. Collection needs to be automated and seamless and not rely on people because when we self report, we say what we think the doctor wants to hear or how we want to be perceived. Wearables fade quickly into the background on their own. There needs to be a bigger context for wearing and reporting your data.
To be effective, feedback needs to be combined with motivational contextual content to keep the patient engaged. Content can be supplied by involving doctors, nurses, and nutritionists in this care. All of this is fed into an algorithm to supply the correct feedback based on available data targeted to the needs of the particular patient. “We are headed to deliberately chosen equalizer motif with motivators like games and we can target the best modifier to improve your health.”
Congestive heart monitoring – This was their first effort and success was determined by measuring readmissions. The process has the patients providing daily uploads of their vitals and coaching based on what is being seen. Feedback is provided and this type of just-in-time care has drastically reduced readmissions.
They have implemented similar programs for blood pressure and diabetes monitoring. Eventually this type of monitoring will be integrated with smart phones, but for now we provide devices. With this data, a provider monitoring a dashboard can reach into the lives of their patients like never before and can provide feedback. For patient engagement, mobile is a game-changer.
Because we are collecting this data and uploading it, we can tell your level of engagement and can tell how much you interact with the clinician and the engagement measure always correlate to the clinical outcomes.
- Make it about everyday life – Integrating daily weather reports with reminders about sunscreen. They were excited to get the weather report, we were excited about the sunscreen message. This is the new wave of healthcare messaging
- Text 2 Move – About type 2 diabetes and improving activities without human intervention. The tool measured a patient’s willingness to be active (first data point) with their actual activity level via wearable, factored in weather, and utilized location-based data. All combined in an algorithm to sends customized messages to the patient and producing significant results
Consumer may want lots of choice, but providers want information and efficiency. As a provider, why do I want everyone’s step count or thousands of normal readings in my EHR? For a busy doctor, the ability to use email would save more lives than a FitBit.
There will probably not be a healthcare version of snapchat or other viral applications, health information just doesn’t work that way.
Putting data in the system is putting the cart before the horse. Our ability to collect data outpaces our ability to analyze it, standards help future-proof our systems, standards help reduce risk. “Standards are the distilled wisdom of distributed failures.” What do you call failing quickly, recovering, and starting again in Silicon Valley? Innovation. What do you call it in healthcare? Malpractice.
4 Trends driving interoperability
- Commoditization of hardware
- Changing distribution of risk in healthcare
- Increased interest of governments
- Emerging technologies to disintermediate proprietary and siloed software systems (Disintermediate – (verb) to attempt to do away with intermediary entities between two primary market forces; to eliminate the middleman)
We are now starting to see a critical mass of devices and the need for standards is taking hold, driving us forward. Healthcare is assuming more risks with these devices and they are forcing change. The next wave of adaptation will be driven by providers to target populations and drive their business more dramatically.
Just to kick things up a bit more, they quoted from the updated Cluetrain Manifesto in regard to web pages versus apps:
- We all love our shiny apps, even when they’re sealed as tight as a Moon base. But put all the closed apps in the world together and you have a pile of apps.
- Put all the Web pages together and you have a new world.
- Web pages are about connecting. Apps are about control.
- In the Kingdom of Apps, we are users, not makers.
- Every new page makes the Web bigger. Every new link makes the Web richer.
- Every new app gives us something else to do on the bus.
“Web pages empower, apps control. I’m not saying don’t build apps, but we are building an ecosystem, let the data out and do something an a broader perspective.”
Session 3: Preparing for a New Level of HIPAA Enforcement
HIPAA enforcement to date – 24 OCR enforcement actions, where money has changed hands. Of those, 23 have been settlements and 1 has been a formal enforcement action. The one entity did “everything wrong.”
Congress pushed for more monetary penalties with HI-TECH, but has not happened yet.
Total settlements to date: $26,133,100 with the average settlement of $947,022 and the fines seem tied to the size of the entity versus the egregious nature of the violations. The government does not seem to be trying to put anyone out of business with these actions.
Breaches have been the driving force, reported by patients or employees. Compliance reviews are driving now things now.
While the odds may be in your favor that you will not have a breach or an audit, they are going down year after year.
The major take away from this session is the need to focus on your risk analysis and encryption process. There is zero tolerance for unencrypted devices in today’s climate.
Day 2 was very busy and I covered many McCormick miles again today. Tomorrow brings a marathon of educations sessions and is capped off with a keynote by President George W. Bush.